Background: Hypercholesterolemia is one of the major modifiable risk factors for atherosclerosis of the coronary and carotid arteries. Although transcranial Doppler (TCD) studies of the cerebral arteries are indicative of decreased cerebral blood flow velocities in patients with hypercholesterolemia, the number of these studies has been limited. The aim of this study was to assess the hemodynamic status of the cerebral arteries in patients with hypercholesterolemia using TCD.Methods: In a case-control study, 60 individuals, including 30 hypercholesterolemic cases (low-density lipoprotein [LDL] > 160 mg/dL) and 30 healthy controls were enrolled. Other arterial risk factors, including diabetes mellitus, hypertension, smoking, and obesity (body mass index > 30), were evaluated and matched as well. TCD was used to assess the hemodynamics of the intracranial arteries as well as the internal carotid arteries. The mean blood flow velocity, pulsatility index, and resistance index were recorded in all the arteries.Results: The mean blood flow velocity, pulsatility index, and resistance index of the intracranial arteries and internal carotid arteries were not significantly different between the two groups (P > 0.05). However, those with higher levels of LDL (>180 mg/dL) showed significantly lower mean blood flow velocity and resistance index of the internal carotid arteries than the healthy controls. In addition, individuals with high-density lipoprotein (HDL) <35 mg/dL had significantly lower mean blood flow velocity in the internal carotid arteries.Conclusion: Hypercholesterolemia (LDL > 160 mg/dL) does not seem to have a detrimental effect on the hemodynamic status of the intracranial arteries and internal carotid arteries. However, in cases of higher LDL (>180 mg/dL) and lower HDL, decreased TCD parameters in the internal carotid arteries, as a surrogate of the peripheral arteries, are prominent.

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